JACK LESLIE LOCK (NPI# 1265917611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265917611 |
| Entity Type | Individual |
| Full Name | JACK LESLIE LOCK |
| Credential | APRN FNP-BC |
| Practice Address |
811 Highway 65 S Dumas AR 71639-3006 |
| Mailing Address |
Po Box 95 De Witt AR 72042-0095 |
| Practice Telephone | 8704563570 |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2018-10-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
A005934 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
811 HIGHWAY 65 S |
| City | DUMAS |
| State | AR |
| Zip Code | 71639-3006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295722668 | Ralph Martin Maxwell | Family Medicine | 811 Highway 65 S, Dumas, AR 71639-3006 | 2005-09-30 |
| 1821605916 | Dustin Seth Hale | Physician Assistant | 811 Highway 65 S, Dumas, AR 71639-3006 | 2020-09-23 |
| 1851956577 | Delta Memorial Hospital | Surgery | 811 Highway 65 S, Dumas, AR 71639-3006 | 2019-05-08 |
| 1912241100 | Roger A Mason Md Pa | Surgery | 811 Highway 65 S, Dumas, AR 71639-3006 | 2012-11-12 |
| 1245568567 | Delta Memorial Hospital | Psychiatric Unit | 811 Highway 65 S, Dumas, AR 71639-3006 | 2009-11-24 |
| 1285867945 | Delta Surgery | Surgery | 811 Highway 65 S, Dumas, AR 71639-3006 | 2009-08-28 |
| 1275760654 | Delta Memorial Hospital | Psychiatric Unit | 811 Highway 65 S, Dumas, AR 71639-3006 | 2009-06-12 |
| 1164437695 | F. David Chambers, M.d. Pa | Family Medicine | 811 Highway 65 S, Dumas, AR 71639-3006 | 2006-07-31 |
| 1245286442 | Franklin David Chambers | Family Medicine | 811 Highway 65 S, Dumas, AR 71639-3006 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619444338 | Susan K Cingolani | Licensed Practical Nurse | 741 Hwy 65 South, Dumas, AR 71639 | 2018-10-31 |
| 1497993166 | Cecily Shae Forrest | Case Manager/Care Coordinator | 708 Hwy 65 South, Dumas, AR 71639 | 2009-02-03 |
| 1922277714 | Amber Gail Bratton | Case Manager/Care Coordinator | 139 S Main Street, Dumas, AR 71639 | 2008-02-26 |
| 1891919189 | Jodie Partridge Center | Day Training, Developmentally Disabled Services | 1180 Highway 165, Dumas, AR 71639 | 2007-04-11 |
| 1487796520 | Freds Stores of Tennessee Inc | Durable Medical Equipment & Medical Supplies | 611 Us Hwy 65 South, Suite A, Dumas, AR 71639 | 2007-02-13 |
| 1629092929 | Delta Memorial Hospital | Home Health | Hwy 65 North, Dumas, AR 71639 | 2006-07-27 |
| 1295767689 | Delta Memorial Hospital | General Acute Care Hospital | 811 Hwy 65 South, Dumas, AR 71639 | 2006-07-07 |
| 1174569206 | City of Dumas | Ambulance | 149 E Waterman St, Dumas, AR 71639 | 2006-06-20 |
| 1346285533 | Lisa M Holaday | Specialist | 811 Hwy 5 S, Dumas, AR 71639 | 2006-06-19 |
| 1518909605 | Shamim A Malik | Psychiatry & Neurology | Delta Memorial Hospital, 811 Highway 65 South, Dumas, AR 71639 | 2006-06-12 |
| Find all providers in zip 71639 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679181283 | Shannon Ruth King | Nurse Practitioner | 6740 East Road M, Dumas, TX 79029 | 2020-07-20 |
| 1497273171 | Shelly Wray | Nurse Practitioner | 1524 Guy Lane Plz, Dumas, TX 79029-5542 | 2017-09-01 |
| 1851568513 | Cheryl Lynn Hornbeck | Nurse Practitioner | 811 Hwy 65 S, Dumas, AR 71639-0887 | 2008-05-13 |
| 1700808268 | Thomas M Lowman | Nurse Practitioner | 145 W Waterman St, Dumas, AR 71639-2139 | 2006-07-24 |
| 1447762646 | Patricia Ann Mohler | Nurse Practitioner | 1524 Guy Lane Plz, Dumas, TX 79029-5542 | 2017-10-27 |
| 1063965697 | Carla L Caballero | Nurse Practitioner | 110 S Bliss Ave, Dumas, TX 79029-3804 | 2016-08-01 |
| 1750732699 | Angela Anderson | Nurse Practitioner | 145 W Waterman St, Dumas, AR 71639-2139 | 2016-06-22 |
| 1952732141 | Jessica Lynn Garriott | Nurse Practitioner | 803 Highway 65 S, Dumas, AR 71639-3006 | 2013-12-12 |
| 1447453725 | Carol L O'neal | Nurse Practitioner | 161 S Main St, Dumas, AR 71639-2222 | 2007-06-06 |
| 1720111990 | Brenda Joyce Jacobs | Nurse Practitioner | 145 W Waterman St, Dumas, AR 71639-2139 | 2007-03-14 |
| Find all providers in DUMAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.